American Association of Blood Banks releases new red blood cell transfusion guidelines.

A 20-member panel of experts based their assessment on a systematic review of research published from 1950 to 2011 to determine optimal use of red blood cells to maximize clinical outcomes and avoid the harms and costs of unnecessary transfusions. The researchers examined the proportion of patients who received any red cell transfusion and the number of red cell units transfused to describe the impact of restrictive transfusion strategies on red blood cell usage. To determine the clinical consequences of a restrictive strategy, the researchers examined overall mortality, non-fatal myocardial infarction, cardiac events, pulmonary edema, stroke, thromboembolism, renal failure, infection, hemorrhage, mental confusion, functional recovery, and length of hospital stay.
Based on the evidence, the panel also suggests adhering to a restrictive transfusion strategy for patients with preexisting cardiovascular disease. Physicians should consider transfusion for patients with symptoms of anemia or a hemoglobin of less than or equal to 8 g/dL. However, the researchers caution that there was some uncertainty about risk for perioperative myocardial infarction associated with this approach. The panel found insufficient evidence to recommend a liberal or restrictive transfusion strategy for patients with acute coronary syndrome.
While physicians most commonly use hemoglobin concentration to decide when to transfuse, the panel suggests that physicians also consider symptoms of anemia in their decision-making.
Source-Eurekalert